WELCOME TO REP LEAGUE REGISTRATION
Fall 2024

Player's First Name

Player's Last Name

Date of Birth

Player's Prior Experience
—Please choose an option—NoneSchoolHouse LeagueSteve Nash - BGCKLSummer CampRep

What age category do you fall in?
—Please choose an option—U10 (born in 2015)U11 (born in 2014)U12 (born in 2013)U13 (born in 2012)U14 (born in 2011)U15 (born in 2010)U16 (born in 2009)U17 (born in 2008)U19 (born in 2006)

Gender
—Please choose an option—MaleFemale

T-Shirt Size
—Please choose an option—Youth SmallYouth MediumYouth LargeYouth XLAdult SmallAdult MediumAdult LargeAdult XL

Medical Conditions

Player's Street Address

Player's City

Player's Postal Code

Parent/Guardian Name (First & Last)
 

Email Address
please list the email address that you use regularly

Secondary Email Address

Cell Phone Number

Home Phone Number

Additional Emergency Contact Name (First & Last)

Relation

Additional Emergency Contact
Cell Phone Number

Additional Emergency Contact
Home Phone Number

LWBA Policy Disclosures

Limited Liability Policy: Liability of the LWBA and/or any of its officials, affiliates, sponsors, or executive members, does not extend to any form of injury, damage or loss resulting from any accident, from known or unknown conditions, handicap, or infection caused while participating in or traveling to or from any LWBA activity.

Photographic Image Policy: Photographic images taken of LWBA houseleague players during practices or in the promotion of the LWBA, may be used at the sole discretion of the LWBA, along with the use of the player's name.

Refund Policy: Refunds will be considered on an exception basis and may be granted at the sole discretion of the LWBA.

Parent / Guardian Acknowledgement: I hereby acknowledge that I have read the above disclosures and my signature indicates my agreement and consent with these terms.

Other Information or Comments

OBA Concussion Policy:

The OBA Concussion Policy is located here. You must read through this policy.

Have you read through the OBA Concussion Policy?
—Please choose an option—Yes

OBA Code of Conduct Policy:

The OBA Code of Conduct Policy is located here. You must read through this policy.

Have you read through the OBA Code of Conduct Policy?
—Please choose an option—Yes

By submitting this registration form you have confirmed that you have read both the OBA Code of Conduct and Concussion Policy and will adhere to the OBA Guidelines required for players within the league.